Influencing Factors of the Morphological Changes of Meibomian Gland before Corneal Refractive Surgery
Le Tian, Dewei Li, Yusu peng, Feifei Zhang, Luqin Wan, Min Chen
Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, School of Ophthalmology, Shandong First Medical University, Qingdao 266071, China
Abstract：Objective: To observe the gland morphology of upper and lower meibomian glands in patients before corneal refractive surgery, and analyze the infuencing factors of the morphological changes of meibomian glands. Methods: This was a retrospective case-control study. From September 2021 to March 2022, we randomly recruited 244 patients (488 eyes), including 101 males (202 eyes) and 143 females (286 eyes), aged from 17 to 51 years, who were treated at Qingdao Eye Hospital of Shandong First Medical University. They were divided into male group and female group according to gender, and each group were further divided into three groups based on age: ≤25 years old group, >25-<35 years old group, and ≥35 years old group. Patients were divided into the wearing group and the control group according to the history of wearing soft contact lenses and were divided into >-6.00 D group and≤-6.00 D group according to the spherical equivalent (SE). The ocular surface function index of patients were detected by the integrated ocular surface analyzer, then, the differences of tear meniscus height (TMH), frst noninvasive breakup time (fNIBUT), average noninvasive breakup time (avNIBUT), and so on were compared in different groups. The Kruskal-Wallis test was used to compare the indexes among different groups. The Eta coeffcient was used to analyze the correlation between sex and meibomian gland loss rate. Spearman correlation analysis was used to analyze the correlations of age, contact lens wearing time, SE, TMH and other indicators with meibomian gland loss rate. Results: There were statistically signifcant differences in fNIBUT, avNIBUT and meibomian gland loss rate between two gender groups (Z=-2.39, P=0.017; Z=-3.19, P=0.001; Z=-3.46, P=0.001). In male patients, the fNIBUT among three age groups had statistically signifcant differences (H=6.42, P=0.040), while other ocular surface function indexes had no statistically signifcant differences (all P>0.05). There were no signifcant differences in TMH, fNIBUT, avNIBUT, meibomian gland loss rate, and meibomian gland bending number among three age groups in female patients (all P>0.05). There was a statistically signifcant difference in the avNIBUT and meibomian gland loss rate between the wearing group and control group (Z=-2.02, P=0.043; Z=-3.43, P=0.001). There was a statistically significant difference in the rate of meibomian gland loss between SE>-6.00 D group and SE -6.00 D group (Z=-1.99, P=0.047). The rate of meibomian gland loss was correlated with sex, age, wearing time of soft contact lenses, SE, and the number of glandular curvatures (Eta correlation coefficient 1.0; r=0.10, P=0.036; r=0.16, P<0.001; r=-0.11, P=0.013; r=0.21, P<0.001). Conclusions: The morphological changes of meibomian gland were mainly manifested as loss of meibomian gland and an increase in gland curvature. The high-risk factors affecting the meibomian gland loss rate included women and high myopia. Special attentions should be paid to the ocular surface function of women with high myopia during the perioperative period of corneal refractive surgery.
田乐, 李德卫, 彭予苏, 等. 角膜屈光术前睑板腺形态的影响因素[J]. 中华眼视光学与视觉科学杂志, 2023, 25(8): 589-595.
Le Tian, Dewei Li, Yusu peng, et al. Influencing Factors of the Morphological Changes of Meibomian Gland before Corneal Refractive Surgery. Chinese Journal of Optometry Ophthalmology and Visual science, 2023, 25(8): 589-595. DOI: 10.3760/cma.j.cn115909-20221017-00394
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